Pharmacology

1- A common side effects of INF treatment is? Neutropenia 2- Antimicrobial prophylaxis for a history of recurrent UTIs TMP-SMZ 3- Antimicrobial prophylaxis for Gonorrhea Ceftriaxone 4 Antimicrobial prophylaxis for Meningococcal infection Rifampin (DOC), minocycline 5 Antimicrobial prophylaxis for PCP TMP-SMZ (DOC), aerosolized pentamidine 6 Antimicrobial prophylaxis for Syphilis Benzathine penicillin G 7 Are Aminoglycosides Teratogenic? Yes 8 Are Ampicillin and Amoxicillin penicillinase resistant? No 9 Are Carbenicillin, Piperacillin, and Ticarcillin penicillinase resistant? No 10 Are Cephalosporins resistant to penicillinase? No, but they are less susceptible than the other Beta lactams 11 Are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant? Yes 12 Clinical use of Isoniazid (INH)? Mycobacterium tuberculosis, the only agent used as solo prophylaxis against TB 13 Common side effects associated with Clindamycin include? Pseudomembranous colitis (C. difficile), fever, diarrhea 14 Common toxicities associated with Fluoroquinolones? GI upset, Superinfections, Skin rashes, Headache, Dizziness 15 Common toxicities associated with Griseofulvin areâ ¦...? Teratogenic, Carcinogenic, Confusion, Headaches 16 Describe the MOA of Interferons (INF) Glycoproteins from leukocytes that block various stages of viral RNA and DNA syn thesis 17 Do Tetracyclines penetrate the CNS? Only in limited amounts 18 Does Ampicillin or Amoxicillin have a greater oral bioavailability? AmOxicillin has greater Oral bioavailability 19 Does Amprotericin B cross the BBB? No 20 Does Foscarnet require activation by a viral kinase? No 21 Foscarnet toxicity? Nephrotoxicity 22 Ganciclovir associated toxicities? Leukopenia, Neutropenia, Thrombocytopenia, Renal toxicity 23 How are INFs used clinically? Chronic Hepatitis A and B, Kaposi's Sarcoma

24 How are Sulfonamides employed clinically? Gram +, Gram -, Norcardia, Chlamydia 25 How are the HIV drugs used clinically? Triple Therapy' 2 Nucleoside RT Inhibitors with a Protease Inhibitor 26 How are the Latent Hypnozoite (Liver) forms of Malaria (P. vivax, P.ovale) tr eated? Primaquine 27 How can Isoniazid (INH)-induced neurotoxicity be prevented? Pyridoxine (B6) administration 28 How can the t1/2 of INH be altered? Fast vs. Slow Acetylators 29 How can the toxic effects fo TMP be ameliorated? With supplemental Folic Acid 30 How can Vancomycin-induced 'Red Man Syndrome' be prevented? Pretreat with antihistamines and a slow infusion rate 31 How do Sulfonamides act on bacteria? As PABA antimetabolites that inhibit Dihydropteroate Synthase, Bacteriostatic 32 How do the Protease Inhibitors work? Inhibt Assembly of new virus by Blocking Protease Enzyme 33 How does Ganciclovir's toxicity relate to that of Acyclovir? Ganciclovir is more toxic to host enzymes 34 How does resistance to Vancomycin occur? With an amino acid change of D-ala D-ala to D-ala D-lac 35 How is Acyclovir used clinically? HSV, VZV, EBV, Mucocutaneous and Genital Herpes Lesions, Prophylaxis in Immunoco mpromised pts 36 How is Amantadine used clinically? Prophylaxis for Influenza A, Rubella ; Parkinson's disease 37 How is Amphotericin B administered for fungal meningitis? Intrathecally 38 How is Amphotericin B used clinically? Wide spectrum of systemic mycoses: Cryptococcus, Blastomyces, Coccidioides, Aspe rgillus, Histoplasma, Candida, Mucor 39 How is Chloramphenical used clinically? Meningitis (H. influenza, N. meningitidis, S. pneumoniae), Conserative treatment due to toxicities 40 How is Foscarnet used clinically? CMV Retinitis in IC pts when Ganciclovir fails 41 How is Ganciclovir activated? Phosphorylation by a Viral Kinase 42 How is Ganciclovir used clinically? CMV, esp in Immunocompromised patients 43 How is Griseofulvin used clinically? Oral treatment of superficial infections 44 How is Leishmaniasis treated? Pentavalent Antimony 45 How is Ribavirin used clinically? for RSV 46 How is Rifampin used clinically? 1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone when used of Lepro sy 3. Used in combination with other drugs 47 How is Trimethoprim used clinically? Used in combination therapy with SMZ to sequentially block folate synthesis 48 How is Vancomycin used clinically? For serious, Gram + multidrug-resistant organisms 49 How would you treat African Trypanosomiasis (sleeping sickness)? Suramin 50 In what population does Gray Baby Syndrome occur? Why?

Premature infants, because they lack UDP-glucuronyl transferase 51 Is Aztreonam cross-allergenic with penicillins? No 52 Is Aztreonam resistant to penicillinase? Yes 53 Is Aztreonam usually toxic? No 54 Is Imipenem resistant to penicillinase? Yes 55 Is Penicillin penicillinase resistant? No - duh 56 IV Penicillin G 57 Mnemonic for Foscarnet? Foscarnet = pyroFosphate analog 58 MOA for Penicillin (3 answers)? 1)Binds penicillin-binding proteins 2) Blocks transpeptidase cross- linking of c ell wall 3) Activates autolytic enzymes 59 MOA: Bactericidal antibiotics Penicillin, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metro nidazole 60 MOA: Block cell wall synthesis by inhib. Peptidoglycan cross-linking (7) Penicillin, Ampicillin, Ticarcillin, Pipercillin, Imipenem, Aztreonam, Cephalosp orins 61 MOA: Block DNA topoisomerases Quinolones 62 MOA: Block mRNA synthesis Rifampin 63 MOA: Block nucleotide synthesis Sulfonamides, Trimethoprim 64 MOA: Block peptidoglycan synthesis Bacitracin, Vancomycin 65 MOA: Block protein synthesis at 30s subunit Aminoglycosides, Tetracyclines 66 MOA: Block protein synthesis at 50s subunit Chloramphenicol, Erythromycin/macrolides, Lincomycin, Clindamycin, Streptogramin s (quinupristin, dalfopristin) 67 MOA: Disrupt bacterial/fungal cell membranes Polymyxins 68 MOA: Unkown Pentamidine 69 MOA:Disrupt fungal cell membranes Amphotericin B, Nystatin, Fluconazole/azoles 70 Name common Polymyxins Polymyxin B, Polymyxin E 71 Name several common Macrolides (3) Erythromycin, Azithromycin, Clarithromycin 72 Name some common Sulfonamides (4) Sulfamethoxazole (SMZ), Sulfisoxazole, Triple sulfas, Sulfadiazine 73 Name some common Tetracyclines (4) Tetracycline, Doxycycline, Demeclocycline, Minocycline 74 Name the common Aminoglycosides (5) Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin 75 Name the common Azoles Fluconazole, Ketoconazole, Clotrimazole, Miconazole, Itraconazole 76 Name the common Fluoroquinolones (6) Ciprofloxacin, Norfloxacin, Ofloxacin, Grepafloxacin, Enoxacin, Nalidixic acid 77 Name the common Non-Nucleoside Reverse Transcriptase Inhibitors Nevirapine, Delavirdine 78 Name the common Nucleoside Reverse Transcriptase Inhibitors

Zidovudine (AZT), Didanosine (ddI), Zalcitabine (ddC), Stavudine (d4T), Lamivudi ne (3TC) 79 Name the Protease Inhibitors (4) Saquinavir, Ritonavir, Indinavir, Nelfinavir 80 Name two classes of drugs for HIV therapy Protease Inhibitors and Reverse Transcriptase Inhibitors 81 Name two organisms Vancomycin is commonly used for? Staphlococcus aureus and Clostridium difficile (pseudomembranous colitis) 82 Oral Penicillin V 83 Resistance mechanisms for Aminoglycosides Modification via Acetylation, Adenylation, or Phosphorylation 84 Resistance mechanisms for Cephalosporins/Penicillins Beta-lactamase cleavage of Beta-lactam ring 85 Resistance mechanisms for Chloramphenicol Modification via Acetylation 86 Resistance mechanisms for Macrolides Methylation of rRNA near Erythromycin's ribosome binding site 87 Resistance mechanisms for Sulfonamides Altered bacterial Dihydropteroate Synthetase, Decreased uptake, or Increased PAB A synthesis 88 Resistance mechanisms for Tetracycline Decreased uptake or Increased transport out of cell 89 Resistance mechanisms for Vancomycin Terminal D-ala of cell wall replaced with D-lac; Decreased affinity 90 Side effects of Isoniazid (INH)? Hemolysis (if G6PD deficient), Neurotoxicity, Hepatotoxicity, SLE-like syndrome 91 Specifically, how does Foscarnet inhibit viral DNA pol? Binds to the Pyrophosphate Binding Site of the enzyme 92 The MOA for Chloramphenicol is ⠦⠦⠦⠦⠦..? Inhibition of 50S peptidyl transferase, Bacteriostatic 93 Toxic effects of TMP include⠦⠦⠦? Megaloblastic anemia, Leukopenia, Granulocytopenia 94 Toxic side effects of the Azoles? Hormone synthesis inhibition (Gynecomastia), Liver dysfunction (Inhibits CYP450) , Fever, Chills 95 Toxicities associated with Acyclovir? Delirium, Tremor, Nephrotoxicity 96 What additional side effects exist for Ampicillin? Rash, Pseudomembranous colitis 97 What antimicrobial class is Aztreonam syngergestic with? Aminoglycosides [snip] What are Amantadine-associated side effects? Ataxia, Dizziness, Slurred speech 99 What are Aminoglycosides synergistic with? Beta-lactam antibiotics 100 What are Aminoglycosides used for clinically? Severe Gram - rod infections. 101 What are common serious side effects of Aminoglycosides and what are these a ssociated with? Nephrotoxicity (esp. with Cephalosporins), Ototoxicity (esp. with Loop Diuretics ) 102 What are common side effects of Amphotericin B? Fever/Chills, Hypotension, Nephrotoxicity, Arrhythmias 103 What are common side effects of Protease Inhibitors? GI intolerance (nausea, diarrhea), Hyperglycemia, Lipid abnormalities, Thrombocy topenia (Indinavir) 104 What are common side effects of RT Inhibitors? BM suppression (neutropenia, anemia), Peripheral neuropathy 105 What are common toxic side effects of Sulfonamides? (5)

-Hypersensitivity reactions -Hemolysis -Nephrotoxicity (tubulointerstitial nephr itis) -Kernicterus in infants Displace other drugs from albumin (e.g., warfarin) 106 What are common toxicities associated with Macrolides? (4) GI discomfort, Acute cholestatic hepatitis, Eosinophilia, Skin rashes 107 What are common toxicities associated with Tetracyclines? GI distress, Tooth discoloration and Inhibition of bone growth in children, Fanc oni's syndrome, Photosensitivity 108 What are common toxicities related to Vancomycin therapy? Well tolerated in general but occasionally, Nephrotoxicity, Ototoxicity, Thrombo phlebitis, diffuse flushing='Red Man Syndrome' 109 What are Fluoroquinolones indicated for? (3) 1.Gram - rods of the Urinary and GI tracts (including Pseudomonas) 2.Neisseria 3 . Some Gram + organisms 110 What are major side effects of Methicillin, Nafcillin, and Dicloxacillin? Hypersensitivity reactions 111 What are Methicillin, Nafcillin, and Dicloxacillin used for clinically? Staphlococcus aureus 112 What are Polymyxins used for? Resistant Gram - infections 113 What are the Anti-TB drugs? Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid (INH) 114 What are the clinical indications for Azole therapy? Systemic mycoses 115 What are the clinical uses for 1st Generation Cephalosporins? Gram + cocci, Proteus mirabilis, E. coli, Klebsiella pneumoniae (PEcK) 116 What are the clinical uses for 2nd Generation Cephalosporins? Gram + cocci, Haemophilus influenza, Enterobacter aerogenes, Neisseria species, P. mirabilis, E. coli, K. pneumoniae, Serratia marcescens ( HEN PEcKS ) 117 What are the clinical uses for 3rd Generation Cephalosporins? 1) Serious Gram - infections resistant to other Beta lactams 2) Meningitis (most penetrate the BBB) 118 What are the clinical uses for Aztreonam? Gram - rods: Klebsiella species, Pseudomonas species, Serratia species 119 What are the clinical uses for Imipenem/cilastatin? Gram + cocci, Gram - rods, and Anerobes 120 What are the Macrolides used for clinically? -Upper respiratory tract infections -pneumonias -STDs: Gram+ cocci (streptococca l infect in pts allergic to penicillin) -Mycoplasma, Legionella,Chlamydia, Neiss eria 121 What are the major structural differences between Penicillin and Cephalospor in? Cephalosporin: 1) has a 6 member ring attached to the Beta lactam instead of a 5 member ring 2)has an extra functional group ( attached to the 6 member ring) 122 What are the major toxic side effects of Imipenem/cilastatin? GI distress, Skin rash, and Seizures at high plasma levels 123 What are the major toxic side effects of the Cephalosporins? 1) Hypersensitivity reactions 2) Increased nephrotoxicity of Aminoglycosides 3) Disulfiram-like reaction with ethanol (those with a methylthiotetrazole group, e .g., cefamandole) 124 What are the side effects of Polymyxins? Neurotoxicity, Acute renal tubular necrosis 125 What are the side effects of Rifampin? Minor hepatotoxicity, Drug interactions (activates P450) 126 What are toxic side effects for Metronidazole? Disulfiram-like reaction with EtOH, Headache 127 What are toxicities associated with Chloramphenicol? Aplastic anemia (dose independent), Gray Baby Syndrome 128 What conditions are treated with Metronidazole? Giardiasis, Amoebic dysentery (E. histolytica), Bacterial vaginitis (Gardnerella

vaginalis), Trichomonas 129 What do Aminoglycosides require for uptake? Oxygen 130 What do you treat Nematode/roundworm (pinworm, whipworm) infections with? Mebendazole/Thiabendazole, Pyrantel Pamoate 131 What drug is given for Pneumocystis carinii prophylaxis? Pentamidine 132 What drug is used during the pregnancy of an HIV + mother?, Why? AZT, to reduce risk of Fetal Transmission 133 What drug is used to treat Trematode/fluke (e.g., Schistosomes, Paragonimus, Clonorchis) or Cysticercosis Praziquantel 134 What is a common drug interaction associated with Griseofulvin? Increases coumadin metabolism 135 What is a mnemonic to remember Amantadine's function? Blocks Influenza A and RubellA; causes problems with the cerebellA 136 What is a prerequisite for Acyclovir activation? It must be Phosphorylated by Viral Thymidine Kinase 137 What is a Ribavirin toxicity? Hemolytic anemia 138 What is an acronym to remember Anti-TB drugs? RESPIre 139 What is an additional side effect of Methicillin? Interstitial nephritis 140 What is an occasional side effect of Aztreonam? GI upset 141 What is Clindamycin used for clinically? Anaerobic infections (e.g., B. fragilis, C. perfringens) 142 What is clinical use for Carbenicillin, Piperacillin, and Ticarcillin? Pseudomonas species and Gram - rods 143 What is combination TMP-SMZ used to treat? Recurrent UTIs, Shigella, Salmonella, Pneumocystis carinii pneumonia 144 What is combined with Ampicillin, Amoxicillin, Carbenicillin, Piperacillin, and Ticarcillin to enhance their spectrum? Clavulanic acid 145 What is Fluconazole specifically used for? Cryptococcal meningitis in AIDS patients and Candidal infections of all types 146 What is Imipenem always administered with? Cilastatin 147 What is Ketoconazole specifically used for? Blastomyces, Coccidioides, Histoplasma, C. albicans; Hypercortisolism 148 What is Metronidazole combined with for 'triple therapy'? Against what organ ism? Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori 149 What is Metronidazole used for clinically? Antiprotozoal: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis Anaerobes: Bacteroides, Clostridium 150 What is Niclosamide used for? Cestode/tapeworm (e.g., D. latum, Taenia species Except Cysticercosis 151 What is Nifurtimox administered for? Chagas' disease, American Trypanosomiasis (Trypanosoma cruzi) 152 What is the chemical name for Ganciclovir? DHPG (dihydroxy-2-propoxymethyl guanine) 153 What is the clinical use for Ampicillin and Amoxicillin? Extended spectrum penicillin: certain Gram + bacteria and Gram - rods 154 What is the clinical use for Nystatin? Topical and Oral, for Oral Candidiasis (Thrush) 155 What is the clinical use for Penicillin? Bactericidal for: Gram + rod and cocci, Gram - cocci, and Spirochetes 156 What is the major side effect for Ampicillin and Amoxicillin?

Hypersensitivity reactions 157 What is the major side effect for Carbenicillin, Piperacillin, and Ticarcill in? Hypersensitivity reactions 158 What is the major toxic side effect of Penicillin? Hypersensitivity reactions 159 What is the memory aid for subunit distribution of ribosomal inhibitors? Buy AT 30, CELL at 50' 160 What is the memory key for Isoniazid (INH) toxicity? INH: Injures Neurons and Hepatocytes 161 What is the memory key for Metronidazole's clinical uses? GET on the Metro 162 What is the memory key for organisms treated with Tetracyclines? VACUUM your Bed Room' 163 What is the memory key involving the '4 R's of Rifampin?' 1. RNA pol inhibitor 2. Revs up P450 3. Red/orange body fluids 4. Rapid resistan ce if used alone 164 What is the MOA for Acyclovir? Inhibit viral DNA polymerase 165 What is the MOA for Amphotericin B? Binds Ergosterol, forms Membrane Pores that Disrupt Homeostatis 166 What is the MOA for Ampicillin and Amoxicillin? Same as penicillin. Extended spectrum antibiotics 167 What is the MOA for Carbenicillin, Piperacillin, and Ticarcillin? Same as penicillin. Extended spectrum antibiotics 168 What is the MOA for Clindamycin? Blocks Peptide Bond formation at the 50S subunit, Bacteriostatic 169 What is the MOA for Methicillin, Nafcillin, and Dicloxacillin? Same as penicillin. Act as narrow spectrum antibiotics 170 What is the MOA for Metronidazole? Forms toxic metabolites in the bacterial cell, Bactericidal 171 What is the MOA for Nystatin? Binds ergosterol, Disrupts fungal membranes 172 What is the MOA for Rifampin? Inhibits DNA dependent RNA polymerase 173 What is the MOA for the Aminoglycosides? Inhibits formation of Initiation Complex, causes misreading of mRNA, Bactericida l 174 What is the MOA for the Azoles? Inhibit Ergosterol synthesis 175 What is the MOA for the Cephalosporins? Beta lactams - inhibit cell wall synthesis, Bactericidal 176 What is the MOA for the Fluoroquinolones? Inhibit DNA Gyrase (topoisomerase II), Bactericidal 177 What is the MOA for the Macrolides? Blocks translocation, binds to the 23S rRNA of the 50S subunit, Bacteriostatic 178 What is the MOA for the Tetracyclines? Binds 30S subunit and prevents attachment of aminoacyl-tRNA, Bacteriostatic 179 What is the MOA for Trimethoprim (TMP)? Inhibits bacterial Dihydrofolate Reductase, Bacteriostatic 180 What is the MOA for Vancomycin? Inhibits cell wall mucopeptide formation, Bactericidal 181 What is the MOA of Amantadine? Blocks viral penetration/uncoating; may act to buffer the pH of the endosome 182 What is the MOA of Aztreonam? Inhibits cell wall synthesis ( binds to PBP3). A monobactam 183 What is the MOA of Foscarnet? Inhibits Viral DNA polymerase 184 What is the MOA of Ganciclovir? Inhibits CMV DNA polymerase

185 What is the MOA of Griseofulvin? Interferes with microtubule function, disrupts mitosis, inhibits growth 186 What is the MOA of Imipenem? Acts as a wide spectrum carbapenem 187 What is the MOA of Isoniazid (INH)? Decreases synthesis of Mycolic Acid 188 What is the MOA of Polymyxins? Bind cell membrane, disrupt osmotic properties, Are Cationc, Basic and act as de tergents 189 What is the MOA of Ribavirin? Inhibits IMP Dehydrogenase (competitively), and therefore blocks Guanine Nucleot ide synthesis 190 What is the MOA of the RT Inhibitors? Inhibit RT of HIV and prevent the incorporation of viral genome into the host DN A 191 What is the most common cause of Pt noncompliance with Macrolides? GI discomfort 192 What is treated with Chloroquine, Quinine, Mefloquine? Malaria (P. falciparum) 193 What microorganisms are Aminoglycosides ineffective against? Anaerobes 194 What microorganisms are clinical indications for Tetracycline therapy? Vibrio cholerae Acne Chlamydia Ureaplasma Urealyticum Mycoplasma pneumoniae Borr elia burgdorferi (Lyme's) Rickettsia Tularemia 195 What microorganisms is Aztreonam not effective against? Gram + and Anerobes 196 What musculo-skeletal side effects in Adults are associated with Floroquinol ones? Tendonitis and Tendon rupture 197 What neurotransmitter does Amantadine affect? How does it influence this NT? Dopamine; causes its release from intact nerve terminals 198 What organism is Imipenem/cilastatin the Drug of Choice for? Enterobacter 199 What organisms does Griseofulvin target? Dermatophytes (tinea, ringworm) 200 What parasites are treated with Pyrantel Pamoate (more specific)? Giant Roundworm (Ascaris), Hookworm (Necator/Ancylostoma), Pinworm (Enterobius) 201 What parasitic condition is treated with Ivermectin? Onchocerciasis ('river blindness'--rIVER-mectin) 202 What populations are Floroquinolones contraindicated in? Why? Pregnant women, Children; because animal studies show Damage to Cartilage 203 What should not be taken with Tetracyclines? / Why? Milk or Antacids, because divalent cations inhibit Tetracycline absorption in th e gut 204 What Sulfonamides are used for simple UTIs? Triple sulfas or SMZ 205 When is HIV therapy initiated? When pts have Low CD4+ (< 500 cells/cubic mm) or a High Viral Load 206 When is Rifampin not used in combination with other drugs? 1. Meningococcal carrier state 2. Chemoprophylaxis in contacts of children with H. influenzae type B 207 Where does Griseofulvin deposit? Keratin containing tissues, e.g., nails 208 Which Aminoglycoside is used for Bowel Surgery ? Neomycin 209 Which antimicrobial classes inhibit protein synthesis at the 30S subunit? (2 ) 1) Aminoglycosides = bactericidal 2) Tetracyclines = bacteriostatic 210 Which antimicrobials inhibit protein synthesis at the 50S subunit? (4)

1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomyc in = bacteriostatic 4)cLindamycin = bacteriostatic 211 Which individuals are predisposed to Sulfonamide-induced hemolysis? G6PD deficient individuals 212 Which RT inhibitor causes Megaloblastic Anemia? AZT 213 Which RT inhibitors cause a Rash? Non-Nucleosides 214 Which RT inhibitors cause Lactic Acidosis? Nucleosides 215 Which Tetracycline is used in patients with renal failure? / Why? Doxycycline, because it is fecally eliminated 216 Who's your daddy? B.W. !!!, Ha. Good Luck on Boards 217 Why are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant? Due to the presence of a bulkier R group 218 Why is Cilastatin administered with Imipenem? To inhibit renal Dihydropeptidase I and decrease Imipenem inactivation in the re nal tubules 219 List the mechanism, clinical use, & toxicity of 5 FU. -S-phase anti-metabolite Pyr analogue -Colon, solid tumors, & BCC/ -Irreversible myelosuppression 220 List the mechanism, clinical use, & toxicity of 6 MP. -inhibits HGPRT (pur. Syn.) - Luk, Lymph, 221 List the mechanism, clinical use, & toxicity of Bleomycin. -DNA intercalator -testicular & lymphomas -Pulmonary fibrosis mild myelosuppress ion. 222 List the mechanism, clinical use, & toxicity of Busulfan. -Alkalates DNA -CML -Pulmonary fibrosis hyperpigmentation 223 List the mechanism, clinical use, & toxicity of Cisplatin. -Alkalating agent -testicular,bladder,ovary,&lung -Nephrotoxicity & CN VIII dama ge. 224 List the mechanism, clinical use, & toxicity of Cyclophosphamide. -Alkalating agent -NHL, Breast, ovary, & lung. - Myelosuppression, & hemorrhagic cystitis. 225 List the mechanism, clinical use, & toxicity of Doxorubicin. -DNA intercalator -Hodgkin's, myeloma, sarcoma, and solid tumors -Cardiotoxicity & alopecia 226 List the mechanism, clinical use, & toxicity of Etoposide. -Topo II inhibitor(GII specific) -Oat cell of Lung & prostate, & testicular -Mye losuppression & GI irritation. 227 List the mechanism, clinical use, & toxicity of Methotrexate. -S-phase anti-metabolite folate analogue -Luk, Lymp, sarc, RA, &psoriasis / -Rev ersible myelosuppression 228 List the mechanism, clinical use, & toxicity of Nitrosureas. -Alkalate DNA -Brain tumors -CNS toxicity 229 List the mechanism, clinical use, & toxicity of Paclitaxel. -MT polymerization stabilizer -Ovarian & breast CA -Myelosupperession & hypersen sitivity. 230 List the mechanism, clinical use, & toxicity of Prednisone. -Triggers apoptosis -CLL, Hodgkin's in MOPP -Cushing-like syndrome 231 List the mechanism, clinical use, & toxicity of Tamoxifen. -Estrogen receptor antagonist -Breast CA -increased endometrial CA risk 232 List the mechanism, clinical use, & toxicity of Vincristine. -MT polymerization inhibitor(M phase) -MOPP, lymphoma, Willm's & choriocarcinoma -neurotoxicity and myelosuppression 233 Which cancer drugs effect nuclear DNA (4)? -Alkalating agents+cisplatin -Doxorubicin+Dactinomycin -Bleomycin -Etoposide 234 Which cancer drugs inhibit nucleotide synthesis(3)? - Methotrexate - 5 FU - 6 mercaptopurine

235 Which cancer drugs work at the level of mRNA(2)? -Steroids -Tamoxifen 236 Which cancer drugs work at the level of proteins(2)? -Vinca alkaloids(inhibit MT) -Paclitaxel 237 ACE inhibitors- clinical use? hypertension, CHF, diabetic renal disease 238 ACE inhibitors- mechanism? reduce levels of Angiotensin II, thereby preventing the inactivation of bradykin in (a potent vasodilator); renin level is increased 239 ACE inhibitors- toxicity? fetal renal damage, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (C APTOPRIL) 240 Acetazolamide- clinical uses? glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness 241 Acetazolamide- mechanism? acts at the proximal convoluted tubule to inhibit carbonic anhydrase. Causes sel f-limited sodium bicarb diuresis and reduction of total body bicarb stores. 242 acetazolamide- site of action? proximal convoluted tubule 243 Acetazolamide- toxicity? hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy 244 Acetazolamide causes? ? ACIDazolamide' causes acidosis 245 Adenosine- clinical use? DOC in diagnosing and abolishing AV nodal arrhythmias 246 ADH antagonists- site of action? collecting ducts 247 adverse effect of Nitroprusside? cyanide toxicity (releases CN) 248 adverse effects of beta-blockers? impotence, asthma, CV effects (bradycardia, CHF, AV block), CNS effects (sedatio n, sleep alterations) 249 adverse effects of Captopril? fetal renal toxicity, hyperkalemia, Cough, Angioedema, Proteinuria, Taste change s, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL) 250 adverse effects of Clonidine? dry mouth, sedation, severe rebound hypertension 251 adverse effects of ganglionic blockers? severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction 252 adverse effects of Guanethidine? orthostatic and exercise hypotension, sexual dysfunction, diarrhea 253 adverse effects of Hydralazine? nausea, headache, lupus-like syndrome, reflex tachycardia, angina, salt retentio n 254 adverse effects of Hydrochlorothiazide? hypokalemia, slight hyperlipidemia, hyperuricemia, lassitude, hypercalcemia, hyp erglycemia 255 adverse effects of Loop Diuretics? K+ wasting, metabolic alkalosis, hypotension, ototoxicity 256 adverse effects of Losartan? fetal renal toxicity, hyperkalemia 257 adverse effects of Methyldopa? sedation, positive Coombs' test 258 adverse effects of Minoxidil? hypertrichosis, pericardial effusion, reflex tachycardia, angina, salt retention 259 adverse effects of Nifedipine, verapamil?

dizziness, flushing, constipation (verapamil), nausea 260 adverse effects of Prazosin? first dose orthostatic hypotension, dizziness, headache 261 adverse effects of Reserpine? sedation, depression, nasal stuffiness, diarrhea 262 Amiodarone- toxicity? pulmonary fibrosis, corneal deposits, hepatotoxicity, skin deposits resulting in photodermatitis, neurologic effects, consitpation, CV (bradycardia, heart block , CHF), and hypo- or hyperthyroidism. 263 antidote? slowly normalize K+, lidocaine, cardiac pacer, and anti-Dig Fab fragments 264 Beta Blockers- CNS toxicity? sedation, sleep alterations 265 Beta Blockers- CV toxicity? bradycardia, AV block, CHF 266 Beta Blockers- site of action? Beta adrenergic receptors and Ca2+ channels (stimulatory) 267 BP? decrease 268 BP? decrease 269 Bretyllium- toxicity? new arrhythmias, hypotension 270 Ca2+ channel blockers- clinical use? hypertension, angina, arrhythmias 271 Ca2+ channel blockers- mechanism? block voltage dependent L-type Ca2+ channels of cardiac and smooth muscle- decre asing contractility 272 Ca2+ channel blockers- site of action? Cell membrane Ca2+ channels of cardiac sarcomere 273 Ca2+ channel blockers- toxicity? cardiac depression, peripheral edema, flushing, dizziness, constipation 274 Ca2+ sensitizers'- site of action? troponin-tropomyosin system 275 Cautions when using Amiodarone? check PFTs, LFTs, and TFTs 276 class IA effects? increased AP duration, increased ERP increased QT interval. Atrial and ventricul ar. 277 class IB- clinical uses? post MI and digitalis induced arrhythmias 278 class IB- effects? decrease AP duration, affects ischemic or depolarized Purkinje and ventricular s ystem 279 class IB- toxicity? local anesthetic. CNS stimulation or depression. CV depression. 280 class IC- effects? NO AP duration effect. useful in V-tach that progresses to V-fib and in intracta ble SVT LAST RESORT 281 class IC- toxicity? proarrhythmic 282 class II- effects? decrease the slope of phase 4, increase PR interval (the AV node is particularly sensitive) 283 class II- mechanism? blocking the beta adrenergic receptor leads to decreased cAMP, and decreased Ca2 + flux 284 class II- toxicity? impotence, exacerbation of asthma, CV effects, CNS effects, may mask hypoclycemi a

285 Class III- effects? increase AP duration, increase ERP, increase QT interval, for use when other arr hythmics fail 286 class IV- clinical use? prevention of nodal arrhythmias (SVT) 287 class IV- effects? decrease conduction velocity, increase ERP, increase PR interval 288 class IV- primary site of action? AV nodal cells 289 class IV- toxicity? constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression) , and torsade de pointes (Bepridil) 290 classes of antihypertensive drugs? diuretics, sympathoplegics, vasodilators, ACE inhibitors, Angiotensin II recepto r inhibitors 291 clinical use? angina, pulmonary edema (also, erection enhancer) 292 clinical use? CHF, atrial fibrillation 293 contractility? increase (reflex response) 294 contractility? decrease 295 contraindications? renal failure, hypokalemia, pt on quinidine 296 decrease Digitoxin dose in renal failure? NO 297 decrease Digoxin dose in renal failure? YES 298 Digitalis- site of action? Na/K ATPase 299 Digoxin v. Digitoxin: bioavailability? Digitoxin>95% Digoxin 75% 300 Digoxin v. Digitoxin: excretion? Digoxin=urinary Digitoxin=biliary 301 Digoxin v. Digitoxin: half life? Digitoxin 168hrs Digoxin 40 hrs 302 Digoxin v. Digitoxin: protein binding? Digitoxin 70% Digoxin 20-40% 303 ejection time? decrease 304 ejection time? increase 305 EKG results? inc PR, dec QT, scooping of ST, and T wave inversion 306 end diastolic volume? decrease 307 end diastolic volume? increase 308 Esmolol- short or long acting? very short acting 309 Ethacrynic Acid- clinical use? Diuresis in pateints with sulfa allergy 310 Ethacrynic Acid- mechanism? not a sulfonamide, but action is the same as furosemide 311 Ethacrynic Acid- toxicity? NO HYPERURICEMIA, NO SULFA ALLERGY; same as furosemide otherwise 312 Furosemide- class and mechanism? Sulfonamide Loop Diuretic. Inhibits ion co-transport system of thick ascending l oop. Abolishes hypertonicity of the medulla, thereby preventing concentration of

the urine. 313 Furosemide- clinical use? edematous states (CHF, cirrhosis, nephrotic syndrome, pulm edema), HTN, hypercal cemia 314 Furosemide- toxicity? (OH DANG) Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial) , Gout 315 Furosemide increases the excretion of what ion? Ca2+ (Loops Lose calcium) 316 HDL effect? no effect 317 HDL effect? increase 318 HDL effect? moderate increase 319 HDL effect? increase 320 HDL effect? DECREASE 321 how do we stop angina? decrease myocardial O2 consumption by: 1-decreasing end diastolic volume 2- decr easing BP 3- decreasing HR 4-decreasing contractility 5-decreasing ejection time 322 HR? increase (reflex response) 323 HR? decrease 324 Hydralazine- class and mechanism? vasodilator- increases cGMP to induce smooth muscle relaxation (arterioles>veins ; afterload reduction) 325 Hydralazine- clinical use? severe hypertension, CHF 326 Hydralazine- toxicity? compensatory tachycardia, fluid retention, lupus-like syndrome 327 Hydrochlorothiazide- clinical use? HTN, CHF, calcium stone formation, nephrogenic DI. 328 Hydrochlorothiazide- mechanism? Inhibits NaCl reabsorption in the early distal tubule. Decreases Ca2+ excretion. 329 Hydrochlorothiazide- toxicity? (hyperGLUC, plus others) Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hy perUricemia, hyperCalcemia, sulfa allergy. 330 Ibutilide- toxicity? torsade de pointes 331 K+- clinical use? depresses ectopic pacemakers, especially in digoxin toxicity 332 K+ sparing diuretics- clinical use? hyperaldosteronism, K+ depletion, CHF 333 K+ sparing diuretics- site of action? cortical collecting tubule 334 K+ sparing diuretics- toxicity? hyperkalemia, endocrine effects (gynecomastia, anti-androgen) 335 LDL effect? moderate decrease 336 LDL effect? large decrease 337 LDL effect? moderate decrease 338 LDL effect? decrease

339 LDL effect? decrease 340 loop diuretics (furosemide)- site of action? thick ascending limb 341 Mannitol- clinical use? ARF, shock, drug overdose, decrease intracranial/intraocular pressure 342 Mannitol- contraindications? anuria, CHF 343 Mannitol- mechanism? osmotic diuretic- increase tubular fluid osmolarity, thereby increasing urine fl ow 344 mannitol- site of action? proximal convoluted tubule, thin descending limb, and collecting duct 345 Mannitol- toxicity? pulmonary edema, dehydration 346 mechanism? vasodilate by releasing NO in smooth muscle, causing and increase in cGMP and sm ooth muscle relaxation (veins>>arteries) 347 mechanism? inhibits the Na/K ATPase, increasing intracellular Na+ decreasing the function o f the Na/Ca antiport causing an increase in intracellular Ca2+ 348 mechanism? Na+ channel blockers. Slow or block conduction. Decreased slope in phase 4 and i ncreased threshold for firing in abnormal pacemaker cells. 349 Mg+- clinical use? effective in torsade de pointes and digoxin toxicity 350 MVO2? decrease 351 MVO2? decrease 352 name five in class II? propanolol, esmolol, metoprolol, atenolol, timolol 353 name four HMG-CoA reductase inhibitors. Lovastatin, Pravastatin, Simvastatin, Atorvastatin 354 name four in class IA. Quinidine, Amiodarone, Procainamide, Disopyramide 355 name four in class III. Sotalol, Ibutilide, Bretylium, Amiodarone 356 name three ACE inhibitors? Captopril, Enalapril, Lisinopril 357 name three calcium channel blockers? Nifedipine, Verapamil, Diltiazem 358 name three in class IB. Lidocaine, Mexiletine, Tocainide 359 name three in class IC. Flecainide, Encainide, Propafenone 360 name three in class IV. Verapamil, Diltiazem, Bepridil 361 name three K+ sparing diuretics? Spironolactone, Triamterene, Amiloride (the K+ STAys) 362 name two bile acid resins. cholestyramine, colestipol 363 name two LPL stimulators. Gemfibrozil, Clofibrate 364 Nifedipine has similar action to? Nitrates 365 preferential action of the Ca2+ channel blockers at cardiac muscle? cardiac muscle: Verapamil>Diltiazem>Nifedipine 366 preferential action of the Ca2+ channel blockers at vascular smooth muscle? vascular sm. Mus.: Nifedipine>Diltiazem>Verapamil

367 Procainamide- toxicity? reversible SLE-like syndrome 368 Quinidine- toxicity? cinchonism: HA, tinnitus, thrombocytopenia, torsade de pointes due to increased QT interval 369 Ryanodine- stie of action? blocks SR Ca2+ channels 370 selectivity? slectively depress tissue that is frequently depolarized (fast tachycardia) 371 side effects/problems? tastes bad and causes GI discomfort 372 side effects/problems? expensive, reversible increase in LFTs, and myositis 373 side effects/problems? red, flushed face which is decreased by ASA or long term use 374 side effects/problems? myositis, increased LFTs 375 side effects/problems? DECREASED HDL 376 Sotalol- toxicity? torsade de pointes, excessive Beta block 377 Spironolactone- mechanism? competitive inhibirot of aldosterone in the cortical collecting tubule 378 TG effect? slight increase 379 TG effect? decrease 380 TG effect? decrease 381 TG effect? large decrease 382 TG effect? no effect 383 thiazides- site of action? distal convoluted tubule (early) 384 toxicity? tachycardia, hypotension, headache - 'Monday disease' 385 toxicity? nausea, vomiting, diarrhea, blurred vision, arrhythmia 386 Triamterene and amiloride- mechanism? block Na+ channels in the cortical collecting tubule 387 Verapamil has similar action to? Beta Blockers 388 what two vasodilators require simultaneous treatment with beta blockers to p revent reflex tachycardia and diuretics to prevent salt retention? Hydralazine and Minoxidil 389 which diuretics cause acidosis? carbonic anhydrase inhibitors, K+ sparing diuretics 390 which diuretics cause alkalosis? loop diuretics, thiazides 391 which diuretics decrease urine Ca2+? thiazides, amiloride 392 which diuretics increase urine Ca2+? loop diuretics, spironolactone 393 which diuretics increase urine K+? all except the K+ sparing diuretics Spironolactone, Triamterene, Amiloride 394 which diuretics increase urine NaCl? all of them 395 Acetaminophen has what two clinical uses and lacks what one clinical use of the NSAIDs?

Acetaminophen has antipyretic and analgesic properties, but lacks anti-inflammat ory properties. 396 Can Heparin be used during pregnancy? Yes, it does not cross the placenta. 397 Can Warfarin be used during pregnancy? No, warfarin, unlike heparin, can cross the placenta. 398 Does Heparin have a long, medium, or short half life? Short. 399 Does Warfarin have a long, medium, or short half life? Long. 400 For Heparin what is the 1. Structure 2. Route of administration 3. Onset of action 4. Mechanism of action 5. Duration of action 6. Ability to inhibit coagul ation in vitro 7. Treatment for overdose 8. Lab value to monitor 9. Site of acti on Heparin 1. Structure - Large anionic polymer, acidic 2. Route of administration - Paranteral (IV, SC) 3. Onset of action - Rapid (seconds) 4. Mechanism of actio n - Activates antithrombin III 5. Duration of action - Acute (hours) 6. Ability to inhibit coagulation in vitro - Yes 7. Treatment for overdose - Protamine sulf ate 8. Lab value to monitor-aPTT (intrinsic pathway) 9. Site of action - Blood 401 For Warfarin what is the 1. Structure 2. Route of administration 3. Onset of action 4. Mechanism of action 5. Duration of action 6. Ability to inhibit coagu lation in vitro 7. Treatment for overdose 8. Lab value to monitor 9. Site of act ion Warfarin 1. Structure - Small lipid-soluble molecule 2. Route of administration -Oral 3. Onset of action - Slow, limited by half lives of clotting factors 4. Me chanism of action - Impairs the synthesis of vitamin K-dependent clotting factor s 5. Duration of action - Chronic (weeks or months) 6. Ability to inhibit coagul ation in vitro - No 402 For Warfarin what is the (continued): 7. Treatment for overdose - IV vitamin K and fresh frozen plasma 8. Lab value to monitor - PT 9. Site of action - Liver 403 Is toxicity rare or common whith Cromolyn used in Asthma prevention? Rare. 404 List five common glucocorticoids. 1. Hydrocortisone 2. Predisone 3. Triamcinolone 4. Dexamethasone 5. Beclomethaso ne 405 Secretion of what drug is inhibited by Probenacid used to treat chronic gout ? Penicillin. 406 The COX-2 inhibitors (celecoxib, rofecoxib) have similar side effects to the NSAIDs with what one exception? The COX-2 inhibitors should not have the corrosive effects of other NSAIDs on th e gastrointestinal lining. 407 What are are the Sulfonylureas (general description) and what is their use? Sulfonylureas are oral hypoglycemic agents, they are used to stimulate release o f endogenous insulin in NIDDM (type-2). 408 What are five advantages of Oral Contraceptives (synthetic progestins, estro gen)? 1. Reliable (no cough) 576 Which drug(s) cause this reaction: Cutaneous flushing (4)? -Niacin -Ca++ channel blockers -adenosine -vancomycin 577 Which drug(s) cause this reaction: Diabetes insipidus? -Lithium 578 Which drug(s) cause this reaction: Disulfram-like reaction (4) ? -Metronidazole -certain cephalosporins -procarbazine -sulfonylureas 579 Which drug(s) cause this reaction: Drug induced Parkinson's (4) ? -Haloperidol -chlorpromazine -reserpine -MPTP 580 Which drug(s) cause this reaction: Extrapyramidal side effects (3)? -Chlorpromazine -thioridazine -haloperidol 581 Which drug(s) cause this reaction: Fanconi's syndrome? -Tetracycline 582 Which drug(s) cause this reaction: Focal to massive hepatic necrosis (4)? -Halothane -Valproic acid -acetaminophen -Amantia phalloides 583 Which drug(s) cause this reaction: G6PD hemolysis(? -Sulfonamides -INH -ASA -Ibuprofen -primaquine -nitrofurantoin /-pyrimethamine chloramphenicol 584 Which drug(s) cause this reaction: Gingival hyperplasia? -Phenytoin 585 Which drug(s) cause this reaction: Gray baby syndrome? -Chloramphenicol 586 Which drug(s) cause this reaction: Gynecomastia (6) ? -Cimetidine -ketoconazole -spironolactone -digitalis -EtOH -estrogens 587 Which drug(s) cause this reaction: Hepatitis? -Isoniazid 588 Which drug(s) cause this reaction: Hot flashes? -Tamoxifen 589 Which drug(s) cause this reaction: Neuro and Nephrotoxic? 0 590 Which drug(s) cause this reaction: Osteoporosis (2)? -Corticosteroids -heparin 591 Which drug(s) cause this reaction: Oto and Nephrotoxicity (3)? -aminoglycosides -loop diuretics -cisplatin 592 Which drug(s) cause this reaction: P450 induction(6)?

-Barbiturates -phenytoin -carbamazipine -rifampin -griseofulvin -quinidine 593 Which drug(s) cause this reaction: P450 inhibition(6)? -Cimetidine -ketoconazole -grapefruit juice -erythromycin -INH -sulfonamides 594 Which drug(s) cause this reaction: Photosensitivity(3)? -Tetracycline -amiodarone -sulfonamides 595 Which drug(s) cause this reaction: Pseudomembranous colitis? -Clindamycin 596 Which drug(s) cause this reaction: Pulmonary fibrosis(3)? -Bleomycin -amiodarone -busulfan 597 Which drug(s) cause this reaction: SLE-like syndrome -Hydralazine -Procainamide -INH -phenytoin 598 Which drug(s) cause this reaction: Stevens-Johnson syn. (3) ? -Ethosuxamide -sulfonamides -lamotrigine 599 Which drug(s) cause this reaction: Tardive dyskinesia? -Antipsychotics 600 Which drug(s) cause this reaction: Tendonitis and rupture? -Fluoroquinolones 601 Which drug(s) cause this reaction: Thrombotic complications? -Oral Contraceptives 602 Which drug(s) cause this reaction: Torsade de pointes (2) ? -Class III antiarrhythmics (sotalol) -class IA (quinidine) 603 Which drug(s) cause this reaction: Tubulointerstitial Nephritis (5)? -Sulfonamides -furosemide -methicillin -rifampin -NSAIDS (ex. ASA) 604 Describe first-order kinetics? Constant FRACTION eliminated per unit time.(exponential) 605 Describe Phase I metabolism in liver(3)? -reduction, oxy, & hydrolysis -H2O sol. Polar product -P450 606 Describe Phase II metabolism in liver(3)? -acetylation, glucuron.,& sulfation -Conjugation -Polar product 607 Explain differences between full and partial agonists(2). - Act on same receptor - Full has greater efficacy 608 Explain potency in relation to full and partial agonists(2). - partial agonist can have increased, decreased, /A21or equal potency as full ag onist. - Potency is an independent factor. 609 How do spare receptors effect the Km? - ED 50 is less than the Km (less than 50% of receptors) 610 How do you calculate maintenance dose? Md= (CpxCL)/F Cp= plas. Conc. CL=clear. F=bioaval. 611 How does a competitive antagonist effect an agonist? -Shifts the curve to the right -increases Km 612 How does a noncompetitive antagonist effect an agonist? - Shifts the curve down -reduces Vmax 613 Name the steps in drug approval(4)? -Phase I (clinical tests) -Phase II -Phase III -PhaseIV (surveillance) 614 Steady state concentration is reached in __#half-lifes In 4 half-lifes= (94%) T1/2 = (0.7x Vd)/CL 615 What is the definition of zero-order kinetics? Example? -Constant AMOUNT eliminated per unit time. -Etoh &ASA 616 What is the formula for Clearance (CL) CL= (rate of elimination of drug/ Plasma drug conc.) 617 What is the formula for Volume of distribution (Vd) Vd= (Amt. of drug in body/ Plasma drug conc.) 618 What is the loading dose formula? Ld= (CpxVd)/F Cp=plasma conc. F= Bioaval. 619 A 12yo patient was treated for a reaction to a bee sting, what drug provides the best coverage of sympathomimetic receptors? Epinephirine(Alpha1,2 and Beta 1,2) 620 A 57 yo heart failure pt develops cardiac decompensation, what drug will giv e you adequate perfusion of his kidneys as well as tx for his Hypotension Dopamine

621 A fellow passenger on a Carnival cruise ship looks pale and diaphoretic, wha t antimuscarinic agent would you give them? scopolamine 622 A group of pts are rushed into the ER complaining of excessive sweating, tea ring, salivation, HA, N and V, muscle twitching, difficulty breathing and diarrh ea. What drug would be the most effective immediate tx Atropine pts are suffering from Cholinestrase inhibitor poisining(Nerve gas/Orga nophosphate poisining) 623 As an Anes you want to use a depolarizing neuromuscular blocking drug on you r pt, what do you use Succinylcholine 624 By what mechanism does this drug help Prevents the release of Ca from SR of skeletal muscle 625 Clonidine is the preferred sym pathomimetic tx of HTN in pts with renal dise ase, why?? Centrally acting alpha agonist, thus causing a decrease in central adrenergic ou tflow, spairing renal blood flow 626 Cocaine casues vasoconstriction and local anesthesia by what mechanism Indirect agonist, uptake inhibitor 627 Cocaine shares is mechanism of action with what antidepressant TCA 628 Dobutamine used for the tx of shock acts on which receptors Beta1 more than B2 629 Guanethidine enhances the release of Norepi? No, it inhibits the release of Nor Epi 630 How does angiotensin II affect NE release? It acts presynaptically to increase NE release. 631 How does botulinum toxin result in respiratory arrest? Prevents the release of ACh, which results in muscle paralysis. 632 How does dantrolene work? Prevents the release of calcium from the sarcoplasmic reticulum of skeletal musc le. 633 How does NE modulate its own release? What other neurotransmitter has this s ame effect? NE acts presynaptically on alpha-2 receptors to inhibit its own release. ACh als o acts presynaptically through M1 receptors to inhibit NE release. 634 How would hemicholinium treatment affect cholinergic neurons? Hemicholinium inhibits the transport of choline into the nerve, thus inhibiting formation of ACh. 635 How would you reverse the effect of a neuromuscular blocking agent? Give an antichloinesterase - neostigmine, edrophonium, etc 636 If a patient is given hexamethonium, what would happen to his/her heart rate ? It would increase to ~ 100 beats/min. Both sympathetic and vagal stimulation wou ld be knocked out, but the SA node has an intrinsic pace of 100 beats/min, which is normally checked by vagal stimulation. 637 Isopoterenol was given to a patient with a developing AV block, why? Stimulates beta adrenergic receptors 638 Norepi feedbacks and inhibits the presynaptic receptor by what mechanism Binding to the presynaptic alpha 2 release modulating receptors 639 Reserpine will block the syntheis of this drug and but not its precursor. Blocks Norepi, but not Dopamine 640 These drugs acts indirectly by releasing strored catecholamines in the presy naptic terminal Amphetamine and Ephedrine 641 What anticholinesterase crosses the blood-brain-barrier? physostigmine 642 What antimuscarinic agent is used in asthma and COPD? Ipratropium 643 What antimuscarinic drug is useful for the tx of asthma

Ipratropium 644 What are the classic symptoms of cholinesterase inhibitor poisoning (parathi on or other organophosphates)? Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal m uscle and CNS, Lacrimation, Sweating, and Salivation = DUMBBELS; also abdominal cramping 645 What are the clinical indications for bethanechol? Activates cholinergic receptors on bladder and bowel smooth muscle, alleviating post-op and neurogenic ileus and urinary retention. 646 What are the clinical indications for neostigmine? Post-op and neurogenic ileus and urinary retention, myasthenia gravis, and rever sal of neuromuscular junction blockade (post-op) through anticholinesterase acti vity. 647 What are the indications for using amphetamine? narcolepsy, obesity, and attention deficit disorder (I wouldn't recommend this) 648 What are the nondepolarizing neuromuscular blocking drugs? Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rapacuronium 649 What are the phases of succinylcholine neuromuscular blockade? Phase 1 = prolonged depolarization, no antidote, effect potentiated by anticholi nesterase; Phase 2 = repolarized but blocked, an anticholinesterase is the antid ote for this phase. 650 What are two indirect acting adrenergic agonists? amphetamine and ephedrine 651 What beta 2 agonist will help your 21yo Astma pt? Albuterol, tertbutaline 652 What cholinergic inhibitor acts by directly inhibiting Ach release at the pr esynaptic terminal Botulinum 653 What cholinomimetic is useful in the diagnosis of Myasthenia Gravis Edrophonium 654 What cholinomimetics might your pt be taking for his glaucoma Carbachol, pilocarpine, physostigmine, echothiophate 655 What class of drug is echothiophate? What is its indication? anticholinesterase glaucoma 656 What conditions would you use dantrolene? In treatment of malignant hyperthermia, due to concomitant use of halothane and succinylcholine. Also in neuroleptic malignant syndrome, a toxicity of antipsych otic drugs. 657 What drug is used to diagnose myasthenia gravis? edrophonium (extremely short acting anticholinesterase) 658 What drugs target this enzyme Neostigmine, pyridostigmine edrophonium physostigmine echothiophate 659 What effect would atropine have on a patient with peptic ulcer disease? Theoretically it could be used to block the cephalic phase of acid secretion (va gal stimulation). 660 What effect would atropine have on the preganglionic sympathetic activation of sweat glands? Would this person sweat? None. No, because atropine would block the postganglionic muscarinic receptors i nvolved in sweat gland stimulation. 661 What enzyme is responsible for the breakdown of ACh in the synaptic cleft? Acetylcholinesterase; ACh is broken down into choline and acetate. 662 What enzyme is responsible for the degredation of Ach Acetylcholine esterase 663 What enzyme is responsible for the production of Ach from Acetyl CoA and Cho line Choline acetyltransferase 664 What is the clinical utility of clonidine? Treatment of hypertension, especially with renal disease (lowers bp centrally, s o flow is maintained to kidney). 665 What is the clinical utility of cocaine?

The only local anesthetic with vasoconstrictive properties. 666 What is the difference between the affinity for beta receptors between albut erol/terbutaline and dantroline? Dobutamine has more of an affintiy for beta-1 than beta-2, and is used for treat ing heart failure and shock. Albuterol and terbutaline is the reverse, and is us ed in treatment of acute asthma. 667 What is the difference in receptor affinity of epinephrine at low doses? Hig h doses? Prefers beta's at low doses, but at higher doses alpha agonist effects are predo minantly seen. 668 What is the effect of epinephrine infusion on bp and pulse pressure? Increased systolic and pulse pressure, decreased diastolic pressure, and little change in mean pressure. 669 What is the effect of guanethidine on adrenergic NE release? It inhibits release of NE. 670 What is the effect of norepinephrine on bp and pulse pressure? Increases mean, systolic, and diastolic bp, while there is little change in puls e pressure. 671 What is the effect of TCA's on the adrenergic nerve? They inhibit reuptake of NE at the nerve terminal (as does cocaine). 672 What is the only depolarizing neuromuscular blocking agent? Succinylcholine 673 What is the receptor affinity and clinical use of isoproterenol? It affects beta receptors equally and is used in AV heart block (rare). 674 What makes this drug effective It antagonizes Ach M receptors and decreases parasym (GI) rxn 675 What nondepolorizing agents could you have used Tubocurarine, atra-, miv-, pan-,ve-, rapacuronium 676 What other substances regulate the Norepi nerve ending Ach, AngiotensinII 677 What other syndrome can this drug tx Neuroleptic malignant syndrome 678 What physiological effects was the Anes using Atropine to tx SLUD (salivation, Lacrimation, urination, Defecation)as well as airway secretion , GI motility, acid secretions 679 What reversal agent could a Anes give to reverse the effects of Atropine Bethanechol, Neostigmine, physostigmine 680 What side effect of using atropine to induce pupillary dilation would you ex pect? Atropine would also block the receptors in the ciliary muscle, causing an impair ment in accommodation (cycloplegia). 681 What sympathomimetic would you not prescribe for hypotension in a pt with re nal artery sclerosis. Norepinephrine (Alpha1,2 and beta 1) 682 What type of neurological blockade would hexamethonium create? Hexamethonium is a nicotinic antagonist, and thus is a ganglionic blocker. 683 What would be the effect on blood pressure with infusion of the alpha -2 ago nist clonidine? Initially vasoconstriction would increase bp, but then it acts on central alpha2 receptors to decrease adrenergic outflow resulting in decreased bp. 684 What would be the next drug that you would give and why Pralidoxime, regenerates active cholinestrase 685 Which antimuscarinic agents are used in producing mydriasis and cycloplegia? atropine, homatropine, tropicamide 686 Which drug increases Sys BP w/o affecting Pulse Pressure Epinephrine 687 Which of epi, norepi, or isoproterenol results in bradycardia? Norepinephrine 688 Which of the following would atropine administration cause? Hypothermia, bra

dycardia, excess salivation, dry flushed skin, or diarrhea Dry flushed skin, due to inhibition of sympathetic post-ganglionic blockade on m uscarinic receptors of sweat glands. All others are opposite of what would be ex pected. 689 Which of these three drugs will cause a reflex bradycardia in your pt (Norep i, Epi, or Isoporterenol) Norepinephrine 690 Which receptors does phenylephrine act upon? alpha-1 > alpha-2; used as a pupil dilator, vasoconstrictor, and for nasal decon gestion 691 While at a tail gait party, you bite into a sandwich that a yellow jacket is also enjoying. Knowing your allergy to this creature, what should you do? Epinephrine to treat anaphylaxis. Also useful if you have open angle glaucoma, a sthma, or hypotension. 692 Why are albuterol and terbutaline effective in tx of acute asthmatic attacks ? These B-2 agonists cause respiratory smooth muscle to relax. [snip] Why does atropine dilate the pupil? Blocking muscarinic receptors in the circular fibers of the eye, results in unop posed action of radial muscles to dilate. 694 Why does NE result in bradycardia? NE increases bp, which stimulates baroreceptors in the carotid sinus and the aor ta. The CNS signals through vagal stimulation to decrease heart rate. 695 Why is carbachol and pilocarpine useful in treatment of glaucoma? They activate the ciliary muscle of the eye (open angle) and pupillary sphincter (narrow angle). 696 Why is pyridostigmine effective in the treatment of myasthenia gravis? As an anticholinesterase it increases endogenous ACh and thus increases strength . 697 Why is reserpine effective in treating HTN? Reserpine inhibits dopamine transport into vesicles, attenuating its conversion to NE by dopamine beta-hydroxylase. 698 Why is there a drop in systolic, mean, and diastolic bp with infusion of iso proterenol? Stimulating beta receptors stimulates heart rate, but beta receptor induced vaso dilation reduces peripheral resistance. 699 Why would a patient with cog-wheel rigidity and a shuffling gait be given be nztropine? Parkinson patients benefit from antimuscarinic agents through its inhibitory act ion within the indirect pathway. 700 Why would dopamine be useful in treating shock? Receptors = D1=D2>beta>alpha, thus increasing heart rate (beta) and blood pressu re (alpha vasoconstriction) while maintaining kidney perfusion (dopamine recepto rs) 701 Why would you give a drug like pancuronium or succinylcholine? Useful in muscle paralysis during surgery or mechanical ventilation. 702 Why would you use pralidoxime after exposure to an organophosphate? Pralidoxime regenerates active cholinesterase. 703 Will Hemicholinum affect the release of stored Ach during Cholinergic Stimul ation No, hemicholinum block the uptake of Choline and thus Ach synthesis 704 Would blockade of muscarininc receptors in the bladder be useful in treating urinary retention? No. Atropine is used to reduce urgency in mild cystitis. So it would aggravate t he urinary retention. 705 Would Hexamethonium be an effective substitute No, hexamethonium targets Nicotinc receptors and will block Parasym, Sym, as wel l as Somatic systems 706 You tx your pt with halothane as well and he has also developed malignant hy pothermia, what drug can you give

Dantrolene 707 Your patient develops a marked arrythmia due to a prolonged depolarization, can you tx this w/ Neostigmine No cholinesterase inhibitors will potentiate the stimulating action of Succinlyc holine 708 Your patient has acute angle glaucoma, does this affect your tx Yes, Scopolamine would antagonize his glaucoma 709 Your patient wants an effective drug to treat his motion sickness, what woul d you prescribe Scopolamine

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-------------------------------------------------------------------------------1 A common side effects of Infection treatment is? Neutropenia Neutropenia: a condition of the blood, in which your white blood cells have a lo w count of neutrophils. Neutrophils, a type of white blood cell, is part of your body s immune system, and it helps fight off bacterial infections. When you have neutropenia, you are at greater risk of infections, and your body is not well-eq uipped to fight back. Neutropenia is a common side effect of chemotherapy and radiation for breast can cer. Because both kinds of treatment can destroy white and red blood cells, it i s important to take a Complete Blood Count test (CBC) often during your treatmen t. A CBC will reveal the count of different kinds of blood cells. Treatments include Neulasta or Neupogen (filgrastim), both of which can stimulat e white blood cell production. When the injections are working, you may experien ce bone pain, which can be alleviated by a soak in a hot bath, or by taking Tyle nol. 2 Antimicrobial prophylaxis for a history of recurrent UTIs TMP-SMZ Oral antibiotics for prophylaxis of urinary tract infections in children Antimicrobial: Trimethoprim/sulfamethoxazole (TMP/SMX) (Bactrim, Septra) Prophylaxis dosage: 2 mg of TMP, 10 mg of SMX per kg as single bedtime or 5 mg o f TMP, 25 mg of SMX per kg twice per week Antimicrobial: Nitrofurantoin (Macrodantin)

Prophylaxis dosage : 1 2 mg/kg as single daily dose Antimicrobial: Cephalexin (Keflex) Prophylaxis dosage: 10 mg/kg as single daily dose Antimicrobial : Amoxicillin Prophylaxis dosage:10 mg/kg as single daily dose Antimicrobial:Sulfisoxazole (Gantrisin Pedatric) Prophylaxis dosage:10 20 mg/kg divided every 12h

3 Antimicrobial prophylaxis for Gonorrhea Ceftriaxone 4 Antimicrobial prophylaxis for Meningococcal infection Rifampin (DOC), minocycline 5 Antimicrobial prophylaxis for PCP TMP-SMZ (DOC), aerosolized pentamidine 6 Antimicrobial prophylaxis for Syphilis Benzathine penicillin G 7 Are Aminoglycosides Teratogenic? Yes 8 Are Ampicillin and Amoxicillin penicillinase resistant? No 9 Are Carbenicillin, Piperacillin, and Ticarcillin penicillinase resistant? No 10 Are Cephalosporins resistant to penicillinase? No, but they are less susceptible than the other Beta lactams 11 Are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant? Yes 12 Clinical use of Isoniazid (INH)? Mycobacterium tuberculosis, the only agent used as solo prophylaxis against TB 13 Common side effects associated with Clindamycin include?

Pseudomembranous colitis (C. difficile), fever, diarrhea 14 Common toxicities associated with Fluoroquinolones? GI upset, Superinfections, Skin rashes, Headache, Dizziness 15 Common toxicities associated with Griseofulvin areâ ¦...? Teratogenic, Carcinogenic, Confusion, Headaches 16 Describe the MOA of Interferons (INF) Glycoproteins from leukocytes that block various stages of viral RNA and DNA syn thesis 17 Do Tetracyclines penetrate the CNS? Only in limited amounts 18 Does Ampicillin or Amoxicillin have a greater oral bioavailability? AmOxicillin has greater Oral bioavailability 19 Does Amprotericin B cross the BBB? No 20 Does Foscarnet require activation by a viral kinase? No 21 Foscarnet toxicity? Nephrotoxicity 22 Ganciclovir associated toxicities? Leukopenia, Neutropenia, Thrombocytopenia, Renal toxicity 23 How are INFs used clinically? Chronic Hepatitis A and B, Kaposi's Sarcoma 24 How are Sulfonamides employed clinically? Gram +, Gram -, Norcardia, Chlamydia 25 How are the HIV drugs used clinically? Triple Therapy' 2 Nucleoside RT Inhibitors with a Protease Inhibitor 26 How are the Latent Hypnozoite (Liver) forms of Malaria (P. vivax, P.ovale) tr eated? Primaquine 27 How can Isoniazid (INH)-induced neurotoxicity be prevented? Pyridoxine (B6) administration

28 How can the t1/2 of INH be altered? Fast vs. Slow Acetylators 29 How can the toxic effects fo TMP be ameliorated? With supplemental Folic Acid 30 How can Vancomycin-induced 'Red Man Syndrome' be prevented? Pretreat with antihistamines and a slow infusion rate 31 How do Sulfonamides act on bacteria? As PABA antimetabolites that inhibit Dihydropteroate Synthase, Bacteriostatic 32 How do the Protease Inhibitors work? Inhibt Assembly of new virus by Blocking Protease Enzyme 33 How does Ganciclovir's toxicity relate to that of Acyclovir? Ganciclovir is more toxic to host enzymes 34 How does resistance to Vancomycin occur? With an amino acid change of D-ala D-ala to D-ala D-lac 35 How is Acyclovir used clinically? HSV, VZV, EBV, Mucocutaneous and Genital Herpes Lesions, Prophylaxis in Immunoco mpromised pts 36 How is Amantadine used clinically? Prophylaxis for Influenza A, Rubella ; Parkinson's disease 37 How is Amphotericin B administered for fungal meningitis? Intrathecally 38 How is Amphotericin B used clinically? Wide spectrum of systemic mycoses: Cryptococcus, Blastomyces, Coccidioides, Aspe rgillus, Histoplasma, Candida, Mucor 39 How is Chloramphenical used clinically? Meningitis (H. influenza, N. meningitidis, S. pneumoniae), Conserative treatment due to toxicities 40 How is Foscarnet used clinically? CMV Retinitis in IC pts when Ganciclovir fails 41 How is Ganciclovir activated? Phosphorylation by a Viral Kinase 42 How is Ganciclovir used clinically?

CMV, esp in Immunocompromised patients 43 How is Griseofulvin used clinically? Oral treatment of superficial infections 44 How is Leishmaniasis treated? Pentavalent Antimony 45 How is Ribavirin used clinically? for RSV 46 How is Rifampin used clinically? 1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone when used of Lepro sy 3. Used in combination with other drugs 47 How is Trimethoprim used clinically? Used in combination therapy with SMZ to sequentially block folate synthesis 48 How is Vancomycin used clinically? For serious, Gram + multidrug-resistant organisms 49 How would you treat African Trypanosomiasis (sleeping sickness)? Suramin 50 In what population does Gray Baby Syndrome occur? Why? Premature infants, because they lack UDP-glucuronyl transferase 51 Is Aztreonam cross-allergenic with penicillins? No 52 Is Aztreonam resistant to penicillinase? Yes 53 Is Aztreonam usually toxic? No 54 Is Imipenem resistant to penicillinase? Yes 55 Is Penicillin penicillinase resistant? No - duh 56 IV Penicillin G 57 Mnemonic for Foscarnet? Foscarnet = pyroFosphate analog 58 MOA for Penicillin (3 answers)?

1)Binds penicillin-binding proteins 2) Blocks transpeptidase cross- linking of c ell wall 3) Activates autolytic enzymes 59 MOA: Bactericidal antibiotics Penicillin, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metro nidazole 60 MOA: Block cell wall synthesis by inhib. Peptidoglycan cross-linking (7) Penicillin, Ampicillin, Ticarcillin, Pipercillin, Imipenem, Aztreonam, Cephalosp orins 61 MOA: Block DNA topoisomerases Quinolones 62 MOA: Block mRNA synthesis Rifampin 63 MOA: Block nucleotide synthesis Sulfonamides, Trimethoprim 64 MOA: Block peptidoglycan synthesis Bacitracin, Vancomycin 65 MOA: Block protein synthesis at 30s subunit Aminoglycosides, Tetracyclines 66 MOA: Block protein synthesis at 50s subunit Chloramphenicol, Erythromycin/macrolides, Lincomycin, Clindamycin, Streptogramin s (quinupristin, dalfopristin) 67 MOA: Disrupt bacterial/fungal cell membranes Polymyxins 68 MOA: Unkown Pentamidine 69 MOA : Disrupt fungal cell membranes Amphotericin B, Nystatin, Fluconazole/azoles 70 Name common Polymyxins Polymyxin B, Polymyxin E 71 Name several common Macrolides (3) Erythromycin, Azithromycin, Clarithromycin 72 Name some common Sulfonamides (4) Sulfamethoxazole (SMZ), Sulfisoxazole, Triple sulfas, Sulfadiazine 73 Name some common Tetracyclines (4)

Tetracycline, Doxycycline, Demeclocycline, Minocycline 74 Name the common Aminoglycosides (5) Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin 75 Name the common Azoles Fluconazole, Ketoconazole, Clotrimazole, Miconazole, Itraconazole 76 Name the common Fluoroquinolones (6) Ciprofloxacin, Norfloxacin, Ofloxacin, Grepafloxacin, Enoxacin, Nalidixic acid 77 Name the common Non-Nucleoside Reverse Transcriptase Inhibitors Nevirapine, Delavirdine 78 Name the common Nucleoside Reverse Transcriptase Inhibitors Zidovudine (AZT), Didanosine (ddI), Zalcitabine (ddC), Stavudine (d4T), Lamivudi ne (3TC) 79 Name the Protease Inhibitors (4) Saquinavir, Ritonavir, Indinavir, Nelfinavir 80 Name two classes of drugs for HIV therapy Protease Inhibitors and Reverse Transcriptase Inhibitors 81 Name two organisms Vancomycin is commonly used for? Staphlococcus aureus and Clostridium difficile (pseudomembranous colitis) 82 Oral Penicillin V 83 Resistance mechanisms for Aminoglycosides Modification via Acetylation, Adenylation, or Phosphorylation 84 Resistance mechanisms for Cephalosporins/Penicillins Beta-lactamase cleavage of Beta-lactam ring 85 Resistance mechanisms for Chloramphenicol Modification via Acetylation 86 Resistance mechanisms for Macrolides Methylation of rRNA near Erythromycin's ribosome binding site 87 Resistance mechanisms for Sulfonamides Altered bacterial Dihydropteroate Synthetase, Decreased uptake, or Increased PAB A synthesis

88 Resistance mechanisms for Tetracycline Decreased uptake or Increased transport out of cell 89 Resistance mechanisms for Vancomycin Terminal D-ala of cell wall replaced with D-lac; Decreased affinity 90 Side effects of Isoniazid (INH)? Hemolysis (if G6PD deficient), Neurotoxicity, Hepatotoxicity, SLE-like syndrome 91 Specifically, how does Foscarnet inhibit viral DNA pol? Binds to the Pyrophosphate Binding Site of the enzyme 92 The MOA for Chloramphenicol is ⠦⠦⠦⠦⠦..? Inhibition of 50S peptidyl transferase, Bacteriostatic 93 Toxic effects of TMP include⠦⠦⠦? Megaloblastic anemia, Leukopenia, Granulocytopenia 94 Toxic side effects of the Azoles? Hormone synthesis inhibition (Gynecomastia), Liver dysfunction (Inhibits CYP450) , Fever, Chills 95 Toxicities associated with Acyclovir? Delirium, Tremor, Nephrotoxicity 96 What additional side effects exist for Ampicillin? Rash, Pseudomembranous colitis 97 What antimicrobial class is Aztreonam syngergestic with? Aminoglycosides [snip] What are Amantadine-associated side effects? Ataxia, Dizziness, Slurred speech 99 What are Aminoglycosides synergistic with? Beta-lactam antibiotics 100 What are Aminoglycosides used for clinically? Severe Gram - rod infections. 101 What are common serious side effects of Aminoglycosides and what are these a ssociated with? Nephrotoxicity (esp. with Cephalosporins), Ototoxicity (esp. with Loop Diuretics )

102 What are common side effects of Amphotericin B? Fever/Chills, Hypotension, Nephrotoxicity, Arrhythmias 103 What are common side effects of Protease Inhibitors? GI intolerance (nausea, diarrhea), Hyperglycemia, Lipid abnormalities, Thrombocy topenia (Indinavir) 104 What are common side effects of RT Inhibitors? BM suppression (neutropenia, anemia), Peripheral neuropathy 105 What are common toxic side effects of Sulfonamides? (5) -Hypersensitivity reactions -Hemolysis -Nephrotoxicity (tubulointerstitial nephr itis) -Kernicterus in infants Displace other drugs from albumin (e.g., warfarin)

106 What are common toxicities associated with Macrolides? (4) GI discomfort, Acute cholestatic hepatitis, Eosinophilia, Skin rashes 107 What are common toxicities associated with Tetracyclines? GI distress, Tooth discoloration and Inhibition of bone growth in children, Fanc oni's syndrome, Photosensitivity 108 What are common toxicities related to Vancomycin therapy? Well tolerated in general but occasionally, Nephrotoxicity, Ototoxicity, Thrombo phlebitis, diffuse flushing='Red Man Syndrome' 109 What are Fluoroquinolones indicated for? (3) 1.Gram - rods of the Urinary and GI tracts (including Pseudomonas) 2.Neisseria 3 . Some Gram + organisms 110 What are major side effects of Methicillin, Nafcillin, and Dicloxacillin? Hypersensitivity reactions 111 What are Methicillin, Nafcillin, and Dicloxacillin used for clinically? Staphlococcus aureus 112 What are Polymyxins used for? Resistant Gram - infections 113 What are the Anti-TB drugs? Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid (INH) 114 What are the clinical indications for Azole therapy? Systemic mycoses 115 What are the clinical uses for 1st Generation Cephalosporins? Gram + cocci, Proteus mirabilis, E. coli, Klebsiella pneumoniae (PEcK)

116 What are the clinical uses for 2nd Generation Cephalosporins? Gram + cocci, Haemophilus influenza, Enterobacter aerogenes, Neisseria species, P. mirabilis, E. coli, K. pneumoniae, Serratia marcescens ( HEN PEcKS ) 117 What are the clinical uses for 3rd Generation Cephalosporins? 1) Serious Gram - infections resistant to other Beta lactams 2) Meningitis (most penetrate the BBB) 118 What are the clinical uses for Aztreonam? Gram - rods: Klebsiella species, Pseudomonas species, Serratia species 119 What are the clinical uses for Imipenem/cilastatin? Gram + cocci, Gram - rods, and Anerobes 120 What are the Macrolides used for clinically? -Upper respiratory tract infections -pneumonias -STDs: Gram+ cocci (streptococca l infect in pts allergic to penicillin) -Mycoplasma, Legionella,Chlamydia, Neiss eria 121 What are the major structural differences between Penicillin and Cephalospor in? Cephalosporin: 1) has a 6 member ring attached to the Beta lactam instead of a 5 member ring 2)has an extra functional group ( attached to the 6 member ring) 122 What are the major toxic side effects of Imipenem/cilastatin? GI distress, Skin rash, and Seizures at high plasma levels 123 What are the major toxic side effects of the Cephalosporins? 1) Hypersensitivity reactions 2) Increased nephrotoxicity of Aminoglycosides 3) Disulfiram-like reaction with ethanol (those with a methylthiotetrazole group, e .g., cefamandole) 124 What are the side effects of Polymyxins? Neurotoxicity, Acute renal tubular necrosis 125 What are the side effects of Rifampin? Minor hepatotoxicity, Drug interactions (activates P450) 126 What are toxic side effects for Metronidazole? Disulfiram-like reaction with EtOH, Headache 127 What are toxicities associated with Chloramphenicol? Aplastic anemia (dose independent), Gray Baby Syndrome 128 What conditions are treated with Metronidazole? Giardiasis, Amoebic dysentery (E. histolytica), Bacterial vaginitis (Gardnerella vaginalis), Trichomonas

129 What do Aminoglycosides require for uptake? Oxygen 130 What do you treat Nematode/roundworm (pinworm, whipworm) infections with? Mebendazole/Thiabendazole, Pyrantel Pamoate 131 What drug is given for Pneumocystis carinii prophylaxis? Pentamidine 132 What drug is used during the pregnancy of an HIV + mother?, Why? AZT, to reduce risk of Fetal Transmission 133 What drug is used to treat Trematode/fluke (e.g., Schistosomes, Paragonimus, Clonorchis) or Cysticercosis Praziquantel 134 What is a common drug interaction associated with Griseofulvin? Increases coumadin metabolism 135 What is a mnemonic to remember Amantadine's function? Blocks Influenza A and RubellA; causes problems with the cerebellA 136 What is a prerequisite for Acyclovir activation? It must be Phosphorylated by Viral Thymidine Kinase 137 What is a Ribavirin toxicity? Hemolytic anemia 138 What is an acronym to remember Anti-TB drugs? RESPIre 139 What is an additional side effect of Methicillin? Interstitial nephritis 140 What is an occasional side effect of Aztreonam? GI upset 141 What is Clindamycin used for clinically? Anaerobic infections (e.g., B. fragilis, C. perfringens) 142 What is clinical use for Carbenicillin, Piperacillin, and Ticarcillin? Pseudomonas species and Gram - rods 143 What is combination TMP-SMZ used to treat? Recurrent UTIs, Shigella, Salmonella, Pneumocystis carinii pneumonia

144 What is combined with Ampicillin, Amoxicillin, Carbenicillin, Piperacillin, and Ticarcillin to enhance their spectrum? Clavulanic acid 145 What is Fluconazole specifically used for? Cryptococcal meningitis in AIDS patients and Candidal infections of all types 146 What is Imipenem always administered with? Cilastatin 147 What is Ketoconazole specifically used for? Blastomyces, Coccidioides, Histoplasma, C. albicans; Hypercortisolism 148 What is Metronidazole combined with for 'triple therapy'? Against what organ ism? Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori 149 What is Metronidazole used for clinically? Antiprotozoal: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis Anaerobes: Bacteroides, Clostridium 150 What is Niclosamide used for? Cestode/tapeworm (e.g., D. latum, Taenia species Except Cysticercosis 151 What is Nifurtimox administered for? Chagas' disease, American Trypanosomiasis (Trypanosoma cruzi) 152 What is the chemical name for Ganciclovir? DHPG (dihydroxy-2-propoxymethyl guanine) 153 What is the clinical use for Ampicillin and Amoxicillin? Extended spectrum penicillin: certain Gram + bacteria and Gram - rods 154 What is the clinical use for Nystatin? Topical and Oral, for Oral Candidiasis (Thrush) 155 What is the clinical use for Penicillin? Bactericidal for: Gram + rod and cocci, Gram - cocci, and Spirochetes 156 What is the major side effect for Ampicillin and Amoxicillin? Hypersensitivity reactions 157 What is the major side effect for Carbenicillin, Piperacillin, and Ticarcill in? Hypersensitivity reactions

158 What is the major toxic side effect of Penicillin? Hypersensitivity reactions 159 What is the memory aid for subunit distribution of ribosomal inhibitors? Buy AT 30, CELL at 50' 160 What is the memory key for Isoniazid (INH) toxicity? INH: Injures Neurons and Hepatocytes 161 What is the memory key for Metronidazole's clinical uses? GET on the Metro 162 What is the memory key for organisms treated with Tetracyclines? VACUUM your Bed Room' 163 What is the memory key involving the '4 R's of Rifampin?' 1. RNA pol inhibitor 2. Revs up P450 3. Red/orange body fluids 4. Rapid resistan ce if used alone 164 What is the MOA for Acyclovir? Inhibit viral DNA polymerase 165 What is the MOA for Amphotericin B? Binds Ergosterol, forms Membrane Pores that Disrupt Homeostatis 166 What is the MOA for Ampicillin and Amoxicillin? Same as penicillin. Extended spectrum antibiotics 167 What is the MOA for Carbenicillin, Piperacillin, and Ticarcillin? Same as penicillin. Extended spectrum antibiotics 168 What is the MOA for Clindamycin? Blocks Peptide Bond formation at the 50S subunit, Bacteriostatic 169 What is the MOA for Methicillin, Nafcillin, and Dicloxacillin? Same as penicillin. Act as narrow spectrum antibiotics 170 What is the MOA for Metronidazole? Forms toxic metabolites in the bacterial cell, Bactericidal 171 What is the MOA for Nystatin? Binds ergosterol, Disrupts fungal membranes 172 What is the MOA for Rifampin? Inhibits DNA dependent RNA polymerase

173 What is the MOA for the Aminoglycosides? Inhibits formation of Initiation Complex, causes misreading of mRNA, Bactericida l 174 What is the MOA for the Azoles? Inhibit Ergosterol synthesis 175 What is the MOA for the Cephalosporins? Beta lactams - inhibit cell wall synthesis, Bactericidal 176 What is the MOA for the Fluoroquinolones? Inhibit DNA Gyrase (topoisomerase II), Bactericidal

177 What is the MOA for the Macrolides? Blocks translocation, binds to the 23S rRNA of the 50S subunit, Bacteriostatic 178 What is the MOA for the Tetracyclines? Binds 30S subunit and prevents attachment of aminoacyl-tRNA, Bacteriostatic 179 What is the MOA for Trimethoprim (TMP)? Inhibits bacterial Dihydrofolate Reductase, Bacteriostatic 180 What is the MOA for Vancomycin? Inhibits cell wall mucopeptide formation, Bactericidal 181 What is the MOA of Amantadine? Blocks viral penetration/uncoating; may act to buffer the pH of the endosome 182 What is the MOA of Aztreonam? Inhibits cell wall synthesis ( binds to PBP3). A monobactam 183 What is the MOA of Foscarnet? Inhibits Viral DNA polymerase 184 What is the MOA of Ganciclovir? Inhibits CMV DNA polymerase 185 What is the MOA of Griseofulvin? Interferes with microtubule function, disrupts mitosis, inhibits growth 186 What is the MOA of Imipenem? Acts as a wide spectrum carbapenem

187 What is the MOA of Isoniazid (INH)? Decreases synthesis of Mycolic Acid 188 What is the MOA of Polymyxins? Bind cell membrane, disrupt osmotic properties, Are Cationc, Basic and act as de tergents 189 What is the MOA of Ribavirin? Inhibits IMP Dehydrogenase (competitively), and therefore blocks Guanine Nucleot ide synthesis 190 What is the MOA of the RT Inhibitors? Inhibit RT of HIV and prevent the incorporation of viral genome into the host DN A 191 What is the most common cause of Pt noncompliance with Macrolides? GI discomfort 192 What is treated with Chloroquine, Quinine, Mefloquine? Malaria (P. falciparum) 193 What microorganisms are Aminoglycosides ineffective against? Anaerobes 194 What microorganisms are clinical indications for Tetracycline therapy? Vibrio cholerae Acne Chlamydia Ureaplasma Urealyticum Mycoplasma pneumoniae Borr elia burgdorferi (Lyme's) Rickettsia Tularemia 195 What microorganisms is Aztreonam not effective against? Gram + and Anerobes 196 What musculo-skeletal side effects in Adults are associated with Floroquinol ones? Tendonitis and Tendon rupture 197 What neurotransmitter does Amantadine affect? How does it influence this NT? Dopamine; causes its release from intact nerve terminals 198 What organism is Imipenem/cilastatin the Drug of Choice for? Enterobacter 199 What organisms does Griseofulvin target? Dermatophytes (tinea, ringworm) 200 What parasites are treated with Pyrantel Pamoate (more specific)?

Giant Roundworm (Ascaris), Hookworm (Necator/Ancylostoma), Pinworm (Enterobius) 201 What parasitic condition is treated with Ivermectin? Onchocerciasis ('river blindness'--rIVER-mectin) 202 What populations are Floroquinolones contraindicated in? Why? Pregnant women, Children; because animal studies show Damage to Cartilage 203 What should not be taken with Tetracyclines? / Why? Milk or Antacids, because divalent cations inhibit Tetracycline absorption in th e gut 204 What Sulfonamides are used for simple UTIs? Triple sulfas or SMZ 205 When is HIV therapy initiated? When pts have Low CD4+ (< 500 cells/cubic mm) or a High Viral Load 206 When is Rifampin not used in combination with other drugs? 1. Meningococcal carrier state 2. Chemoprophylaxis in contacts of children with H. influenzae type B 207 Where does Griseofulvin deposit? Keratin containing tissues, e.g., nails 208 Which Aminoglycoside is used for Bowel Surgery ? Neomycin 209 Which antimicrobial classes inhibit protein synthesis at the 30S subunit? (2 ) 1) Aminoglycosides = bactericidal 2) Tetracyclines = bacteriostatic 210 Which antimicrobials inhibit protein synthesis at the 50S subunit? (4) 1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomyc in = bacteriostatic 4)cLindamycin = bacteriostatic 211 Which individuals are predisposed to Sulfonamide-induced hemolysis? G6PD deficient individuals 212 Which RT inhibitor causes Megaloblastic Anemia? AZT 213 Which RT inhibitors cause a Rash? Non-Nucleosides 214 Which RT inhibitors cause Lactic Acidosis? Nucleosides

215 Which Tetracycline is used in patients with renal failure? / Why? Doxycycline, because it is fecally eliminated 216 Who's your daddy? B.W. !!!, Ha. Good Luck on Boards 217 Why are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant? Due to the presence of a bulkier R group 218 Why is Cilastatin administered with Imipenem? To inhibit renal Dihydropeptidase I and decrease Imipenem inactivation in the re nal tubules 219 List the mechanism, clinical use, & toxicity of 5 FU. -S-phase anti-metabolite Pyr analogue -Colon, solid tumors, & BCC/ -Irreversible myelosuppression 220 List the mechanism, clinical use, & toxicity of 6 MP. -inhibits HGPRT (pur. Syn.) - Luk, Lymph, 221 List the mechanism, clinical use, & toxicity of Bleomycin. -DNA intercalator -testicular & lymphomas -Pulmonary fibrosis mild myelosuppress ion. 222 List the mechanism, clinical use, & toxicity of Busulfan. -Alkalates DNA -CML -Pulmonary fibrosis hyperpigmentation 223 List the mechanism, clinical use, & toxicity of Cisplatin. -Alkalating agent -testicular,bladder,ovary,&lung -Nephrotoxicity & CN VIII dama ge. 224 List the mechanism, clinical use, & toxicity of Cyclophosphamide. -Alkalating agent -NHL, Breast, ovary, & lung. - Myelosuppression, & hemorrhagic cystitis. 225 List the mechanism, clinical use, & toxicity of Doxorubicin. -DNA intercalator -Hodgkin's, myeloma, sarcoma, and solid tumors -Cardiotoxicity & alopecia 226 List the mechanism, clinical use, & toxicity of Etoposide. -Topo II inhibitor(GII specific) -Oat cell of Lung & prostate, & testicular -Mye losuppression & GI irritation. 227 List the mechanism, clinical use, & toxicity of Methotrexate. -S-phase anti-metabolite folate analogue -Luk, Lymp, sarc, RA, &psoriasis / -Rev ersible myelosuppression

228 List the mechanism, clinical use, & toxicity of Nitrosureas. -Alkalate DNA -Brain tumors -CNS toxicity 229 List the mechanism, clinical use, & toxicity of Paclitaxel. -MT polymerization stabilizer -Ovarian & breast CA -Myelosupperession & hypersen sitivity. 230 List the mechanism, clinical use, & toxicity of Prednisone. -Triggers apoptosis -CLL, Hodgkin's in MOPP -Cushing-like syndrome 231 List the mechanism, clinical use, & toxicity of Tamoxifen. -Estrogen receptor antagonist -Breast CA -increased endometrial CA risk 232 List the mechanism, clinical use, & toxicity of Vincristine. -MT polymerization inhibitor(M phase) -MOPP, lymphoma, Willm's & choriocarcinoma -neurotoxicity and myelosuppression 233 Which cancer drugs effect nuclear DNA (4)? -Alkalating agents+cisplatin -Doxorubicin+Dactinomycin -Bleomycin -Etoposide 234 Which cancer drugs inhibit nucleotide synthesis(3)? - Methotrexate - 5 FU - 6 mercaptopurine 235 Which cancer drugs work at the level of mRNA(2)? -Steroids -Tamoxifen 236 Which cancer drugs work at the level of proteins(2)? -Vinca alkaloids(inhibit MT) -Paclitaxel 237 ACE inhibitors- clinical use? hypertension, CHF, diabetic renal disease 238 ACE inhibitors- mechanism? reduce levels of Angiotensin II, thereby preventing the inactivation of bradykin in (a potent vasodilator); renin level is increased 239 ACE inhibitors- toxicity? fetal renal damage, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (C APTOPRIL) 240 Acetazolamide- clinical uses? glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness 241 Acetazolamide- mechanism? acts at the proximal convoluted tubule to inhibit carbonic anhydrase. Causes sel f-limited sodium bicarb diuresis and reduction of total body bicarb stores.

242 acetazolamide- site of action? proximal convoluted tubule 243 Acetazolamide- toxicity? hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy 244 Acetazolamide causes? ? ACIDazolamide' causes acidosis 245 Adenosine- clinical use? DOC in diagnosing and abolishing AV nodal arrhythmias 246 ADH antagonists- site of action? collecting ducts 247 adverse effect of Nitroprusside? cyanide toxicity (releases CN) 248 adverse effects of beta-blockers? impotence, asthma, CV effects (bradycardia, CHF, AV block), CNS effects (sedatio n, sleep alterations) 249 adverse effects of Captopril? fetal renal toxicity, hyperkalemia, Cough, Angioedema, Proteinuria, Taste change s, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL) 250 adverse effects of Clonidine? dry mouth, sedation, severe rebound hypertension 251 adverse effects of ganglionic blockers? severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction

252 adverse effects of Guanethidine? orthostatic and exercise hypotension, sexual dysfunction, diarrhea 253 adverse effects of Hydralazine? nausea, headache, lupus-like syndrome, reflex tachycardia, angina, salt retentio n 254 adverse effects of Hydrochlorothiazide? hypokalemia, slight hyperlipidemia, hyperuricemia, lassitude, hypercalcemia, hyp erglycemia

255 adverse effects of Loop Diuretics? K+ wasting, metabolic alkalosis, hypotension, ototoxicity 256 adverse effects of Losartan? fetal renal toxicity, hyperkalemia 257 adverse effects of Methyldopa? sedation, positive Coombs' test 258 adverse effects of Minoxidil? hypertrichosis, pericardial effusion, reflex tachycardia, angina, salt retention

259 adverse effects of Nifedipine, verapamil? dizziness, flushing, constipation (verapamil), nausea 260 adverse effects of Prazosin? first dose orthostatic hypotension, dizziness, headache 261 adverse effects of Reserpine? sedation, depression, nasal stuffiness, diarrhea 262 Amiodarone- toxicity? pulmonary fibrosis, corneal deposits, hepatotoxicity, skin deposits resulting in photodermatitis, neurologic effects, consitpation, CV (bradycardia, heart block , CHF), and hypo- or hyperthyroidism. 263 antidote? slowly normalize K+, lidocaine, cardiac pacer, and anti-Dig Fab fragments 264 Beta Blockers- CNS toxicity? sedation, sleep alterations 265 Beta Blockers- CV toxicity? bradycardia, AV block, CHF 266 Beta Blockers- site of action? Beta adrenergic receptors and Ca2+ channels (stimulatory) 267 BP? decrease 268 BP? decrease 269 Bretyllium- toxicity? new arrhythmias, hypotension

270 Ca2+ channel blockers- clinical use? hypertension, angina, arrhythmias 271 Ca2+ channel blockers- mechanism? block voltage dependent L-type Ca2+ channels of cardiac and smooth muscle- decre asing contractility 272 Ca2+ channel blockers- site of action? Cell membrane Ca2+ channels of cardiac sarcomere 273 Ca2+ channel blockers- toxicity? cardiac depression, peripheral edema, flushing, dizziness, constipation 274 Ca2+ sensitizers'- site of action? troponin-tropomyosin system 275 Cautions when using Amiodarone? check PFTs, LFTs, and TFTs 276 class IA effects? increased AP duration, increased ERP increased QT interval. Atrial and ventricul ar. 277 class IB- clinical uses? post MI and digitalis induced arrhythmias 278 class IB- effects? decrease AP duration, affects ischemic or depolarized Purkinje and ventricular s ystem 279 class IB- toxicity? local anesthetic. CNS stimulation or depression. CV depression. 280 class IC- effects? NO AP duration effect. useful in V-tach that progresses to V-fib and in intracta ble SVT LAST RESORT 281 class IC- toxicity? proarrhythmic 282 class II- effects? decrease the slope of phase 4, increase PR interval (the AV node is particularly sensitive) 283 class II- mechanism? blocking the beta adrenergic receptor leads to decreased cAMP, and decreased Ca2

+ flux 284 class II- toxicity? impotence, exacerbation of asthma, CV effects, CNS effects, may mask hypoclycemi a 285 Class III- effects? increase AP duration, increase ERP, increase QT interval, for use when other arr hythmics fail 286 class IV- clinical use? prevention of nodal arrhythmias (SVT) 287 class IV- effects? decrease conduction velocity, increase ERP, increase PR interval 288 class IV- primary site of action? AV nodal cells 289 class IV- toxicity? constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression) , and torsade de pointes (Bepridil) 290 classes of antihypertensive drugs? diuretics, sympathoplegics, vasodilators, ACE inhibitors, Angiotensin II recepto r inhibitors 291 clinical use? angina, pulmonary edema (also, erection enhancer) 292 clinical use? CHF, atrial fibrillation 293 contractility? increase (reflex response) 294 contractility? decrease 295 contraindications? renal failure, hypokalemia, pt on quinidine 296 decrease Digitoxin dose in renal failure? NO 297 decrease Digoxin dose in renal failure?

YES 298 Digitalis- site of action? Na/K ATPase 299 Digoxin v. Digitoxin: bioavailability? Digitoxin>95% Digoxin 75% 300 Digoxin v. Digitoxin: excretion? Digoxin=urinary Digitoxin=biliary